For weeks, Sen. Blanche Lincoln has been attacked as a "flip-flopper" or an obstructionist in television ads aimed at Arkansas voters, who will decide next year if she gets to keep her job.
This week, she and other moderate Democrats who made a politically risky vote to start debate on the Senate's health care bill may get a bit of positive support from two campaigns, funded by reform advocates, highlighting their votes to allow debate on the Democrats' bill.
It's a rarity among political ads, which tend to highlight the negative aspect of important votes, but they're just two in a slew of health-related television advertising and grass-roots campaigning expected between now and the end of the year, when the Senate plans to hold a vote on the bill.
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Families USA and PhRMA, the pharmaceutical-industry trade group, are airing the ads in Arkansas this week with hopes of airing similar ads in the states of other "swing-vote" lawmakers.
"It's a tip of the hat to Sen. Lincoln, in this case, for taking a chance," said Ken Johnson, PhRMA spokesman. "Clearly, this is one of the most important public policy debates of our lifetime, and we believe that it deserves a full and open debate."
Health Care for America Now, another group that supports Democrats' reform plans, is airing similar ads in Arkansas, as well as in Nebraska, home of swing-vote Democratic Sen. Ben Nelson.
But don't expect the heat from the left or right to slow down just yet. FDL Action PAC, a liberal group, released an online video Tuesday with a split-screen of Ms. Lincoln explaining her opposition to the public insurance plan and sick Arkansans asking for coverage.
Before the vote, Ms. Lincoln faced ads from liberal groups urging her to vote for the motion and ads from the Republican National Committee arguing that if she votes for the procedural motion and then against the bill, she's a "flip-flopper."
A Zogby poll released last week suggests the political risks Ms. Lincoln may face.
The telephone survey of 501 likely Arkansas voters, conducted Nov. 16-17, showed Ms. Lincoln in a statistical tie - holding on to a 41 percent to 39 percent lead - with Republican state Sen. Gilbert Baker, considered likely to seek the seat. But when the respondents were asked whom they would favor under the stipulation that Ms. Lincoln had backed the Democratic health care bill, Ms. Lincoln badly trailed Mr. Baker, by 49 percent to 37 percent.
Already, outside groups have spent $3.3 million on health-related advertising in Arkansas alone, Ms. Lincoln said in a recent speech on the Senate floor, when she announced she would provide the 60th vote needed to start debate. Advocacy groups on both sides of the debate have poured money into states such as Nebraska, Maine, North Dakota, Indiana, Louisiana and Connecticut - the homes of lawmakers who could become swing voters.
Democrats plan to start formal debate on the legislation, which is President Obama's top legislative priority, after the Thanksgiving break. In a sign of the bruising battle to come, the procedural motion to start debate passed on Saturday on a party-line vote of 60-39, with not a single vote to spare.
For months, advocacy groups issued ads broadly focused on why passing a reform bill was good or bad. In recent weeks, groups have declared more firm positions and poured even more money into the fight.
The Employment Policies Institute, for instance, waited to start television advertising until about two weeks ago, when it become clear that reform was going in a direction it couldn't support.
"I was hopeful that they were going to come up with some reasonable reforms, but it doesn't look like it. So we elected to engage and tell people where we think this is going," said Rick Berman, executive director of the group, which is spending more than $12 million in swing states to highlight the Senate bill's taxes, cuts to the Medicare program and fines if individuals don't obtain insurance.
But some question whether the ads would have any impact on voters, though negative advertising has been credited with bringing down the 1993 attempt to pass a health care reform bill.
"I don't think they convert anybody," said Ken Bowler, executive vice president at Dow Lohnes Government Strategies LLC and former House Ways and Means staff director. "They just arouse your believers," he said.
"We are committed to making sure that at a minimum, there is a balance, if not an even greater volume of ads in support of moving health reform forward," said Ron Pollack, executive director of Families USA, a group that supports the House and Senate bills and a part of the group sponsoring the Lincoln ads. "This is really the climactic period where we will determine whether health reform happens or not, and we plan to be very involved."
The liberal advocacy group MoveOn.org sent an e-mail to members this week asking for donations to run reform-related ads.
"We need to maximize the pressure on fence-sitting conservative Democrats in the Senate with a hard-hitting new ad campaign. Do even more to make an example of some of those who voted the wrong way in the House. Take on the U.S. Chamber of Commerce's lies about reform to neutralize their opposition," the e-mail said.
New ads against reform were also released this week from Employers for a Healthy Economy, a coalition of business groups including the U.S. Chamber of Commerce, and the 60-Plus Association, a conservative group for older Americans.
The American Medical Association and AARP started running a new ad on Monday arguing that health reform won't cut Medicare benefits to counteract Republicans' claims that proposals to cut $500 billion in purported Medicare waste would have an impact on benefits.